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PubMed1993

[Possibilities of using the sartorius muscle in the treatment of chronic osteoarticular infections].

In a group of 17 patients with chronic osteoarticular infection for filling of the chronic cavity the sartorius muscle was used. In eight instances chronic osteomyelitis of the distal femur was involved, in nine instances by means of the sartorius muscle the acetabulum was filled (after removal of an infected total endoprosthesis or after resection of the hip joint on account of purulent coxitis). In the first group the authors recorded 75% satisfactory results and therefore they recommend to use the sartorius muscle for filling chronic osteomyelitic cavities in the distal part of the femur with a fistula on the inner side of the thigh. In the second group of patients, where the sartorius muscle was used to fill the acetabulum, poor results were recorded in 55.5%. This is obviously associated with the blood supply of the muscle used, which does not permit such an extensive mobilization and rotation of the muscle without jeopardizing its nutrition. Therefore the authors do not recommend the use of the sartorius muscle for filling the acetabulum and propose other muscle flaps which gave preliminary, satisfactory results.

Acetabulum↗
PubMed1996

Diagnostic radiology in Legg-Calvé-Perthes disease.

To assess lateral subluxation of the femoral head, the acetabulum-head index (AHI) was determined on 37 bilateral radiographs and arthrograms from children with unilateral Legg-Clavé-Perthes disease (LCPD). To establish reliable normal limits for the AHI, the non-affected hip was regarded as normal material. On radiographs, the lower normal rate was 80.7. On arthrograms, if the bony acetabular edge was used as the lateral margin of the acetabulum, the lower normal rate was 68.4 and if the labrum was used as landmark, the corresponding rate was 86. To establish normal medial joint space (MJS) and migration percentage (MP) values, 166 hip radiographs from 83 healthy children aged between 3 and 12 years were evaluated. The MJS values varied according to age and sex, the mean upper normal value being 11.2 mm; MP values were dependent on age only, the mean upper normal value being 20.8. Specific upper normal MJS and MP values were established for each age and sex group. To determine the corresponding values on arthrograms, the arthrograms and radiographs of the contralateral hips of 37 children with unilateral LCPD were used, the upper normal MJS and MP values being 5.7 and 31, respectively, which were unrelated to either age or sex. By using these normal values on the radiographs and arthrograms of the 37 affected hips, we found MP to be the best method for detecting whether or not a Perthes hip was contained within the acetabulum. The role of conventional radiography and bone scintigraphy was investigated in predicting the radiological outcome of LCPD in 75 children (86 hips). Bone scintigraphy provided more accurate information concerning the extent of the necrotic process than did the initial radiographs. Moreover it could reveal revascularization and consequently the stage of the disease. Revascularization may occur as early as one month after the onset of symptoms. However, the method was unable to predict the outcome of the disease in some of the cases, especially when it was performed late after the onset of symptoms. Conventional radiography provides important information about other parameters, such as "head-at-risk" signs, which facilitate treatment selection. Of these signs, not only lateral subluxation but also metaphyseal changes strongly predispose to severe deformity of the hip joint. In a prospective study of 22 patients (24 hips) with LCPD, the early conventional radiographs, arthrograms, bone scans and MR images were evaluated. MR imaging gave earlier and more reliable information about the real extent of necrosis of the femoral head, compared with radiography and scintigraphy. Furthermore, revascularization could be more clearly demonstrated on MR images than on scintigrams. MR imaging and arthrography were alike, however, as regards to reveal lateral subluxation, while radiography was less sensitive. The value of MR imaging for assessing the configuration and structure of the femoral head was investigated in comparison with radiography in 10 patients with healed LCPD. MR imaging provided no further important information, compared to radiography. Moreover, the relationship between radiological and clinical results was investigated, but there was insufficient correlation between radiological findings and clinical outcome. Most of the patients did well even though their hip images showed considerable changes.

Acetabulum↗
PubMed1996

[Fatigue rupture of a Harris-Galante shell in contact with an autograft of the femur head. Analysis of bone, mechanical and metallurgical factors].

We observed, after 38 months of follow-up, the rupture of the metallic shell of a Harris-Galante cup implanted in a dysplastic acetabulum augmented with a femoral head autograft. Bone ingrowth was extended to 53% of the porous surface, but only in the areas in contact with the true acetabulum. No bone ingrowth was identified in the fiber mesh in contact with the autograft. The graft was necrotic on histologic examination and showed collapse radiographically. These last conditions were responsible for shear stress in the part of the cup that was in contact with the graft-acetabulum junction. These stresses were involved in the fatigue rupture mechanism identified on microscopic examination of rupture surfaces. We observed metallic structure anomalies in the failed cup by comparing with another Harris-Galante cup considered as a reference: larger alpha elements, reduction of the titanium equiaxial structure. These defects could be related to uncontrolled temperature during the sintering process utilized for fiber mesh fixation. These structural anomalies, by reducing the metallic fatigue strength, potentiated the deleterious effect of partial bone ingrowth and graft collapse.

Acetabulum↗
PubMedDate not supplied

Radiological study of severe proximal femoral focal deficiency.

Twenty-two hips in 20 children, all classified as Amstutz type 3 proximal femoral focal deficiency, were studied by means of plain radiographs, arthrograms (30), ultrasound examination (six), computed tomography (CT) scans (including five arthrographies with CT) and magnetic resonance imaging (MRI; nine). These investigations demonstrated that in 15 hips, the superior femoral epiphysis was mobile in the acetabulum, whereas in six others, it was fixed and fused to the acetabulum. In one case, it was impossible to prove whether the epiphysis was mobile or fixed. The key radiologic and other image features that allow these conclusions to be drawn are described. The therapeutic implications are important, as it would be pointless or harmful to attempt to consolidate the femoral neck or put it into valgus when the epiphysis is spontaneously fixed to the acetabulum.

Acetabulum↗
PubMed1976

Pathology of the limbus in untreated teratologic congenital dislocation of the hip. A case report of a ten-month-old- infant.

A dislocated hip in a 10-month-old infant with multiple congenital anomalies was examined postmortem. The true acetabulum was filled with areolar tissue and the acetabular articular cartilage was covered by fibrous pannus. The secondary acetabulum consisted of fibrous capsular tissue lined by synovial cells. A lip of new fibrous tissue, the limbus, grew over the cartilaginous labrum of the true acetabulum in juxtaposition to the dislocated femoral head.

Abnormalities, Multiple↗
PubMed2005

Comparison of one-dimensional and two-dimensional functionally graded materials for the backing shell of the cemented acetabular cup.

Among the factors that have been suggested as contributing to the failure of a total joint replacement are stress shielding and the subsequent bone resorption. Recent studies have shown that when a backing shell made from a Ti alloy is used, high stresses are generated in the cement at the edges of the cup, and low stresses are generated at the dome of the bone in the acetabulum; thus, the bone at the dome suffers stress shielding and the cement edge suffers high stresses. The aim of this study was to investigate the effect of using a functionally graded material (FGM), instead of Ti alloy, for the backing shell (BS) on the stress distribution in the BS-cement-bone system. Finite-element and optimization techniques were used to obtain the optimal distribution of materials in the tangential direction only of the backing (1D FGM) as well as in the tangential and radial directions of the backing (2D FGM). It was found that the stress distribution in the BS-cement-bone system was about the same, regardless of whether the BS was fabricated from a 1D or 2D FGM. The stress-shielding factor in the bone at the dome of the acetabulum and the maximum von Mises stress in cement at the cement interfaces for 1D and 2D FGM were reduced by about 51%, 69%, and 50%, respectively, compared to the case when the shell was fabricated from a Ti alloy. The optimal elastic modulus of the 1D FGM was obtained with the materials graded from HA at the dome of the acetabulum to a Ti alloy at the rim of the shell. The optimal elastic modulus of the 2D FGM was obtained with the materials graded from Ti alloy at the right edge of the rim, to Bioglass 45S5 at the left edge of the rim, and to HA at the dome of the shell.

Bone Substitutes↗
PubMed1979

[Delayed complications after dislocations and fractures in the pelvic region (author's transl)].

In the case of surgically dressed necroses of the hip condyle and coxarthroses a condition was found after fracture of the pelvis or after dislocation of the hip joint in 7.2% of the cases. In 13.2% of the cases a trauma was found anamnestically. It was subdivided into fractures of the acetabulum, fractures of the pelvic girdle, dislocations, and fractures of the pelvic brim on the basis of the system of Judet and Engler as well as Feldkamp. Fractures of the pelvic brim through muscular traction, traction of the ligament, and direct trauma were discussed. The most frequent delayed consequences arising after dislocations of the hip joint and fractures of the acetabulum are: necroses of the head of the femur, coxarthroses, pseudarthroses, and myositis ossificans. The pathogenesis of the delayed injuries resulted from: capsular and vascular lesions, damage to cartilage with fractures in the spongiosa region, incongruence of the surface of the joint, insufficiency of the static structure of the pelvic ring, deposit of calcium salt outside the bone. In some cases the progress of the necrosis could be arrested by means of osteotomy and spongiosa filling. The rate of necrosis increases in proportion to the period between the time of occurrence of the accident and reposition (limit of 6 h). Even though about half the pelvic girdle fractures show good results with conservative treatment, in the case of fractures of the acetabulum a reconstruction as far as possible continuous and without stages is to be aimed at. In many cases the development of a myositis ossificans cannot be prevented.

Adolescent↗
PubMed1997

[Total hip replacement in presence of acetabular dysplasia type II according to the AAOS classification.].

GOAL OF SURGERY: Incorporation of the acetabular cup in ideal position in patients with a primary dysplastic acetabulum. Two thirds of the surface of the cup must be covered by bone. INDICATIONS: Joint replacement in patients with acetabular dysplasia type II according to the AAOS classification. CONTRAINDICATIONS: Presence of acetabular dysplasia types I and III according to the AAOS classification. PREOPERATIVE WORK UP: Radiographic measurement of the acetabular depth and width using templates. POSITIONING AND ANAESTHESIA: Supine, affected side of pelvis slightly elevated. General or spinal anaesthesia. Special set of instruments mandatory. SURGICAL TECHNIQUE: Insertion of an acetabular cup through a lateral approach. Reaming of the acetabulum and filling of the defect under compression with a mixture of autogenous, morcellized bone from the resected femoral head and fibrin glue. Coverage of the transplanted bone with a pedicled capsular flap. POSTOPERATIVE MANAGEMENT: Phlebitis prophylaxis. Walking with 2 forearm crutches on the first postoperative day. Removal of stitches after 10 days. Thereafter gradual increase of weight bearing (10 kg every second day, use a bathroom scale to check loading). Once full weight bearing and full muscle control have been reached, use of 1 crutch is allowed. Radiographic control after 6 weeks, 3,6 and 12 months and yearly thereafter. POSSIBLE COMPLICATIONS: Perforation of the bony acetabulum. Fracture of the anterior or posterior acetabular rim. Thrombophlebitis, lung embolism, infection and/or periarticular ossification. RESULTS: Between 1986 and 1994 the technique has been used in 140 hips with congenital dysplasia (type II according to the AAOS classification) and secondary osteoarthritis. 132 hips were regularly assessed and the mean of follow-up was 6.2 years (1 to 9 years). The mean age of the mostly female patients was 48 years (28 to 62 years). Only porous surfaced metallic cups without cement were used. The following complications were observed: thrombophlebitis 1, superficial infection 1, transient paresis of the fibular nerve 1 and transient irritation of the femoral nerve 3 (see Table 2). Additional complications such as thigh pain, periarticular ossification and resorption of the bone graft are listed in Table 3. Complete bony incorporation of the bone grafts was seen in 122 hips. Resorption up to 8 mm occurred in the remaining 10 hips.

English Abstract↗
PubMed2004

Clear cell chondrosarcoma of the proximal femur with intrapelvic extension.

Clear cell chondrosarcoma is a rare tumor that can be easily confused with benign tumors. The aim of this report is to present a case that is rare, initially diagnosed as aneurysmal bone cyst and then chondroblastoma, and has an interesting extension pattern. A 41-year-old male patient was treated for an apparently benign cystic lesion of the right proximal femur by intralesional excision and bone grafting. The pathological diagnosis was aneurysmal bone cyst. Two years later, the patient presented with a pathological fracture at the same site and a total hip arthroplasty was performed. The pathological specimen was diagnosed as chondroblastoma. Three years later, clinical and radiological examination of the patient revealed a large mass located on the intrapelvic side of the acetabulum. There was no evidence of distant metastases. Both tumors were resected with a wide margin on the femoral side and a marginal margin on the intrapelvic side. The extremity was reconstructed with a resection-type total hip prosthesis. Again, the pathological diagnosis was chondroblastoma. The patient developed a deep infection that was treated by antibiotic therapy and surgical debridement. One year later, there was recurrence of the femoral and intrapelvic masses and right hemipelvectomy was performed; the specimen was reported as clear cell chondrosarcoma. Since then, the patient has been leading an active life, and there is no evidence of local recurrence or distant metastasis. Clinically and pathologically, clear cell chondrosarcoma may be confused with benign bone tumors. This caused a delay in the final diagnosis of this patient and he received inadequate surgical treatment, leading to a hemipelvectomy. We also found that the intrapelvic mass seemed to have developed independently on the intrapelvic side of the acetabulum. We were unable to find an exact explanation for this finding and postulated that tumor cells might have been seeded into the inner wall of the acetabulum during acetabular preparation of the total hip prosthesis.

Adult↗
PubMed1994

High hip center in revision arthroplasty.

What is the effect of superior placement of the acetabulum in complex hip reconstruction? Twenty-two patients (23 cases) had revision hip arthroplasty with superiorly placed porous-coated components without bone-grafts. Cemented femoral components were used in 21 cases and ingrowth components in 2. The average vertical height (corrected for magnification) was 36.8 mm from the interteardrop line, compared to a contralateral normal height of 12.1 mm. Three patients were deceased. The remaining 19 patients (20 hips) had a minimum 2-year follow-up period (average, 35 months). Fourteen hips had two or more previous surgeries. Seven acetabular components had thin (< 1 mm), nonprogressive, incomplete radiolucent lines. One acetabulum had a complete 1 mm radiolucent line in an asymptomatic patient. The remaining 12 acetabular components had no evidence of radiolucent lines and none of the acetabular components migrated. One hip with a cemented femoral component had evidence of possible loosening. Two cemented femoral components had evidence of definite loosening, one with minimal clinical symptoms and the other was revised to a long stem at 14 months after revision. Of the two ingrown femoral components, one had initial subsidence of 1.5 cm and both had thigh pain. All other patients had improved from their preoperative status; however, 4 of 20 hips had moderate to severe pain. Superior cup position did not result in concomitant lateral position. With a short-term follow-up period however, vertical displacement alone resulted in high loosening rates, with 25% for the femur and 5% for the acetabulum.

Activities of Daily Living↗
PubMed2005

Three-dimensional hip morphology analysis using CT transverse sections to automate diagnoses and surgery managements.

This paper describes an image analysis method that evaluates bone morphology of hip structures including the femur stem, trochanter, neck and head, acetabulum, and pelvis to automate hip diagnoses and surgical managements. On every CT transverse section, radial B-spline curves are used to approximate the ellipse-like acetabulum and femur head and stem. The femur neck is approximated as trapezoid-like and the pelvis horizontally symmetrical structure. The centers of the ellipse-like structures from transverse sections are used to determine 3D axes of the femur stem, head, and acetabulum. The centerlines of the neck or the pelvis on the sections are used to determine the neck axis or pelvis centerplane. Boundary changes of these structures are recognized as concave, convex and hole features that are then identified as fractures, tumors, and spurs. Based on the geometric evaluations of these structures and features, hip surgeries including tumor dissect and bone graft, open reduction using plates, screws and nails, and arthroplasty are automatically managed to achieve the normal hip function including dissection of tumors and reduction of dislocations and angular deviations between the hip structures. This prototype system can be used as a qualitative and quantitative tool for the diagnosis of various hip diseases and for the planning of accurate surgical procedures. A series of examples and four case studies illustrate this automated method can be used to accurately diagnose hip diseases and manage hip surgeries, and train operators.

Adult↗
PubMed2001

"In vivo" determination of hip joint separation and the forces generated due to impact loading conditions.

Numerous supporting structures assist in the retention of the femoral head within the acetabulum of the normal hip joint including the capsule, labrum, and ligament of the femoral head (LHF). During total hip arthroplasty (THA), the LHF is often disrupted or degenerative and is surgically removed. In addition, a portion of the remaining supporting structures is transected or resected to facilitate surgical exposure. The present study analyzes the effects of LHF absence and surgical dissection in THA patients. Twenty subjects (5 normal hip joints, 10 nonconstrained THA, and 5 constrained THA) were evaluated using fluoroscopy while performing active hip abduction. All THA subjects were considered clinically successful. Fluoroscopic videos of the normal hips were analyzed using digitization, while those with THA were assessed using a computerized interactive model-fitting technique. The distance between the femoral head and acetabulum was measured to determine if femoral head separation occurred. Error analysis revealed measurements to be accurate within 0.75mm. No separation was observed in normal hips or those subjects implanted with constrained THA, while all 10 (100%) with unconstrained THA demonstrated femoral head separation, averaging 3.3mm (range 1.9-5.2mm). This study has shown that separation of the prosthetic femoral head from the acetabular component can occur. The normal hip joint has surrounding capsuloligamentous structures and a ligament attaching the femoral head to the acetabulum. We hypothesize that these soft tissue supports create a passive, resistant force at the hip, preventing femoral head separation. The absence of these supporting structures after THA may allow increased hip joint forces, which may play a role in premature polyethylene wear or prosthetic loosening.

Biomechanical Phenomena↗
PubMed2006

[Fence grafting for acetabular reconstruction with a cementless cup].

Acetabular reconstruction is difficult after loss of bone stock and socket remodeling. Several techniques have been proposed ranging from a metal backing to allografting. We propose fence grafting. After explantation, the acetabulum is carefully cleaned of all interface tissue and precisely measured. If the vertical diameter is clearly greater than the anteroposterior diameter, a tricortical graft is harvested from the iliac crest and modeled to perfectly fit between the anterioinferior iliac spine and the residual posterior wall as well as the fundus medially. One or two oblique screws are inserted for stabilization. Any superior bone loss is filled by bone substitute (without mechanical value). The acetabulum is then reamed from the obturator foramen sparing the anterior and posterior columns. Residual bony defects are filled with cancellous bone. A hemispheric cup is then press fit and maintained with two or three screws. We performed this procedure in eight patients with SO.F.C.O.T. stage III acetabular loosening with segmentary bone loss and an oval acetabular cavity. Clinical follow-up was more than four years. The Postel-Merle-d'Aubigné score improved from 9.8 to 15.7 on average. Radiographically, there were no implant mobilization or migration and no circumferential lucent lines were observed. A nearly anatomic position was achieved in all cases except two (technical imperfection). At more than one-year follow-up, the grafts could not be distinguished from adjacent bone. For us, high-positioned or jumbo cups do not offer a satisfactory reconstruction option. There is a risk of compression with allografts from a head bank. We have not used the cemented metal-backed solution nor impacted grafts. The major drawback with fence grafting is the iliac harvesting (possible residual limping because of the extensive disinsertion of the gluteus medius. The reliable acetabular reconstruction is the major advantage. This technique is not simply an acetabular block widened laterally but it decreases the vertical dimension. This is a reliable but minute technique which allows true long-lasting reconstruction of the acetabulum.

Adult↗
PubMed1997

Radiotherapy in stage IIA and IIB testicular seminoma with reduced portals: a prospective multicenter study.

PURPOSE: A prospective multicenter study was carried out to estimate the treatment outcome of radiotherapy in Stage II seminoma after the application of modern staging and radiotherapy techniques. The lower margin of the iliac field was positioned on the upper rim of the acetabulum to reduce the amount of scattered irradiation to the remaining testicle. METHODS AND MATERIALS: The study was carried out in 25 centers in Germany. Patients with pure seminoma, negative AFP-values, and retroperitoneal lymph node metastases of less than 5 cm in diameter were entered into the study. All patients received a ventrodorsal opposed field irradiation of the para-aortic and the ipsilateral iliac lymph nodes. The fields extended from the top of the 11th thoracic vertebra to the top of the acetabulum. Patients in Stage IIA (lymph nodes <2 cm ) received 30 Gy, and patients with Stage IIB (lymph nodes between 2 and 5 cm) 36 Gy total dose. RESULTS: 39 patients in Stage IIA and 19 patients in Stage IIB were evaluated. After a median observation time of 37 months all patients are alive and disease free. Recurrence free survival in stage IIA was 100%. Two patients in Stage IIB experienced a recurrence 10 and 17 months after the end of radiotherapy. The actuarial recurrence free survival estimate in Stage IIB was 94.1% for 1 year and 87.4% for 2 years. One recurrence in Stage IIB occurred in the mediastinum, one in the mediastinum, and one the lung. Both patients could be salvaged by chemotherapy. There were no pelvic recurrences. The treatment was well tolerated, with nausea being the most common side effect (56.9% Grade 1, 15.5% Grade 2, and 8.6% Grade 3). Diarrhea occurred in 15.5% (Grade 1), 15.5% (Grade 2), and 5.2% (Grade 3) of the patients. CONCLUSIONS: The outcome of para-aortic and ipsilateral iliac irradiation in Stage IIA/B testicular seminoma is excellent with the currently available staging methods and treatment facilities. The treatment is well tolerated. The lower margin of the iliacal field can be placed at the acetabulum.

Adult↗
PubMed1990

Early loosening of revision hip arthroplasty. A roentgen stereophotogrammetric analysis.

The primary migration of 15 and 22 cemented acetabular and femoral prosthetic components was recorded in 23 patients operated because of type I (minimal endosteal bone loss) and type II (thinning of bone, enlargement of femoral canal and acetabulum) mechanical loosening. Roentgen stereophotogrammetric analysis was used to measure the three-dimensional displacements of the center of the acetabulum and the femoral head. All but 1 of the acetabular and 1 of 15 revised femoral stem prostheses migrated within 2 years after the operation, whereas 5 of 7 revised femoral surface arthroplasties were stable. Femoral components with type II loosening migrated, on average, 1.5 mm (range, 0.6-3.0 mm) during the first postoperative year, compared with 0.7 mm (range, 0.3-1.1 mm) in patients with type I loosening (P less than .02). Increased bone loss of the acetabulum (type II), the quality of the bone-cement interface as judged from radiographs, and the presence of perforation of the femoral cortex did not significantly influence the rate of migration in this group. Compared with previously presented studies of cemented primary hip prostheses, cemented revisions seem not only to migrate more frequently but also at a higher rate. Poor primary fixation is probably one important cause of the high frequency of clinical failures in these patients.

Adult↗
PubMed1987

Extensile exposure of the hip for revision arthroplasty.

The authors describe a lateral approach to the hip without trochanteric osteotomy that allows sufficient access to the femur and acetabulum for revision total hip arthroplasty. When bone loss is extensive, this approach permits massive autograft/allograft arthroplasty of the proximal femur and acetabulum. This approach follows anatomic muscle planes, maintains abductor function, and allows wound closure with a viable muscle cuff around the acetabulum and upper femur. The exposure is adequate for anatomic placement of components and correction of leg length discrepancy.

Follow-Up Studies↗
PubMed1996

Neglected congenital dislocation of the hip. Role of computed tomography and computer-aided design for total hip arthroplasty.

Computed tomography (CT) provides important three-dimensional anatomic details in congenital dislocation of the hip that are useful for total hip arthroplasty (THR) and are not obtainable with conventional radiographic evaluation. In this study, 84 patients (119 hips) with congenital dislocation of the hip were evaluated with CT before surgery. Specifically, both the acetabulum and the femur were analyzed to make the best selection of the prosthesis. The average anteversion of the acetabulum was 23 degrees, with an opening of 30.9 mm and a depth of 14.7 mm. The bone stock of the true acetabulum was calculated and the average available diameter for the acetabular implant was 44.9 mm. The CT topogram revealed the true leg-length discrepancy (average 0.5-1.9 cm), and the amount of a shortening osteotomy when necessary was determined. Finally, to determine the stem with optimum fit and fill, a three-dimensional reconstruction of the femoral canal using CT data and computer-aided design (CAD) was matched with a three-dimensional geometry of several stem designs and sizes obtained from a CAD system.

Computer-Aided Design↗
PubMed1977

Mesocoelium malayanum sp. n. (Digenea: Brachycoeliidae) in a frog, Rana macrodon Dumeril and Bibron 1941, from Malaysia.

Mesocoelium malayanum sp. n. is described from the frog Rana macrodon, in Malaysia. Elongate body, broader anteriorly, measuring 1.900 (1.679-2.070) mm long by 0.404 (0.380-0.437) wide, tegument aspinose oral sucker 0.212 (0.200-0.228) by 0.202 (9.191-0.205), acetabulum 0.141 (0.132-0.150) by 0.139 (0.123-0.146), prepharynx present, oesophagus 0.115 (0.096-0.137), caeca reaching posterior 1/3 of body, anterior testis 0.097 (0.087-0.110) by 0.091 (0.087-0.100) dorsal to acetabulum, posterior testis 0.094 (0.087-0.101) by 0.092 (0.091-0.100), cirrus pouch 0.121 (0.111-0.130) by 0.047 (0.041-0.055), genital pore at left of midline of oesophagus just anterior to intestinal bifurcation, ovary 0.110 (0.091-0.127) by 0.089 (0.085-0.096) on left of body and posterior to acetabulum, vitelline glands with single follicles extending from intestinal bifurcation to ends of caeca, excretory vesicle I-shaped and eggs 0.040 (0.037-0.046) by 0.023 (0.022-0.024). Although morphologically related to M. maroccanum and M. meggitti, M. malayanum is considered to be a new species.

Animals↗